Medicaid is no free ride

July 5, 2012 at 5:56 PM (Uncategorized) (, , , )

  I hereby give permission, if anyone is discussing Medicaid with their conservative relatives and friends (Since the Supremes decision to make it optional brings it back into the news a bit) to use the following personal story to underscore the fact that 1. Medicaid is not “free” healthcare, and 2. Does not cover everything.

In Ohio, if you are on Medicaid, there is a portion of that called a “spenddown.”
You have to either incur your spenddown each month,(as in some vast hospital bill you could never hope to pay, in full) or pay your spenddown each month before benefits from Medicaid kick in.

Mine is 204.00.  I can’t get by with just incurring that because I now need personal care inside my home  So I pay 204.00 each month as my share of that care.

Neither Medicare nor Medicaid will  cover lymphedema supplies. (I’m on both)  Socks, compression stockings, velcro compression materials are an ongoing expense of about 50.00 every month.

Repairs and batteries for my powerchair are questioned because of an ambiguity in the Medicaid change (the creation of a bidding process on repairs to save $$$ at the beginning of 2011. Long story short, the company that made my chair can’t bill Medicaid to fix my chair, (“our bid wasn’t the lowest” ) and the ones that could bill them don’t want to repair the chair…”It’s custom, we don’t have to…”

But, I couldn’t live independently in the community without Medicaid. Because of Medicaid I have transportation to medical care…covered prescriptions are discounted, and I’m finally on some physical therapy to try to combat muscle atrophy/rigidity that happens to some sedentary folks with cerebral palsy as they age.

I’m listing all this out because it is  concrete proof that Medicaid, the thing I have that keeps me out of some human warehouse at age 50, the thing I’m quite grateful to have, is not free.
Not by a long shot.

(It’s important to note, legislators, that this kind of help costs the state about half as much as warehousing me, which they were darn near ready to do in February…when I said, “Um no, I’m not going into a nursing home because only skilled staff can put on two bandages no matter how important this bandaging is to my lymphedema. Just no.” And eventually got some outpatient patchwork solutions going.

Medicaid Beneficiaries are not lazy.

Keeping my care going, making it to the appointments, making necessary lifestyle changes monitoring my lymphedema daily, carving time out to do home therapy…..etc, while trying to take care of a rather feisty little LexiTheMiniatureSchnauzer…
…Takes at leas as much mental effort as a part time job, and often a full time one.

The optional Medicaid expansion offered by the ACA  will be a vital benefit to the lower income people it would serve…But it’s not some license to sit on the couch and order up expensive medical tests.  It’s a flawed, nutty bureaucratic nightmare that nonetheless is better than going without.

And I’m sick to death of libertarian philosophies, being applied on the ground in such a way as to obscure and mischaracterize the necessity of these services.

I was quite encouraged watching Laurence O’Donnell and Howard Dean subbing on Morning Joe this am,discussing forces within the medical community that might just force governors who are presently ideologically opposed to the Medicaid expansion to go ahead and take the money in 2014.

Push back when you can…when they start ranting about socialism and entitlements.

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3 Comments

  1. Attilathemom said,

    Argh!! I’ve been spending weeks between SS and our bank. I got so damn frustrated today I practically broke down and cried. Spent 3 hours yesterday at SS to get a certain paper, which the assistant assured me was “exactly what the bank wants” only to be turned away AGAIN. How freaking hard can it be to set up a representative payee account? grrrrr

    • imfunny2 said,

      Yes, a friend back in Co is doing the exact same thing…. 😦 it’s a PITA let me tell you.

  2. silver account said,

    Spend down is another name for the Medically Needy Program. You can be reimbursed for unpaid medical bills if, by paying them, your income would be low enough to qualify you for Medicaid coverage. For example, a family of four with an income of $1,000 a month would be covered if their medical expenses were at least $692 a month. Doctor visits, prescriptions, past medical bills, and medical insurance charges are covered. If you have other insurance it must pay first. Only the amount that it doesn’t pay may be counted. this program is for children and pregnant women only.

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